Automated retrieval and delivery of medications

ABSTRACT

This invention relates to a process and a device for automatically delivering and retrieving singular medication from a plurality of containers or product blister packages, storing and recording medication transactions for each patient, and the crushing of designated medications. This invention also relates to medication control, delivery, consumption verification and monitoring within institutional entities.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. patent application Ser. No.12/390,994 filed Feb. 23, 2009 and claims the benefit of U.S.Provisional Application No. 61/066,524, filed Feb. 21, 2008.

BACKGROUND OF THE INVENTION

This invention relates to a process and a device for automaticallyretrieving singular medication from a plurality of containers orpackaged product packs, storing and recording medication transactionsfor each patient, and the crushing of designated medications. Thisinvention also relates to medication control, dispensing/delivery,consumption verification and monitoring within institutional entities.

Institutional entities such as correctional systems, nursing homes,assisted living centers and hospitals require the accurateadministration of medications to a plurality of patients. This processcan be time intensive with numerous opportunities for human error. Thedocumentation of medication administration is often done manually, andis a tedious, inaccurate process that can be difficult to monitor.Maintaining an accurate inventory of medications, physical security, andaccountability of controlled medications often requires additionalpersonnel. Additionally, the linking of the delivery process and thebilling process for medication is often inconsistent, and can be furthercomplicated by inaccurate documentation and/or human error.

Another problem arises in the institutional environment when medicationis left with the patient. The potential exists for abuse and/or theft ofpatient retained medication and patient compliance with dosageinstructions is difficult to oversee and track. And again, problemsrelated to theft and patient compliance are further compounded by thesame inaccuracies and human error previously mentioned.

Secure institutions must ensure the accurate distribution andconsumption of single pills by their patients. However, the labor costsassociated with tracking a single pill exceed the costs associated withtracking a blister package. Thus, the preferred approach for dispensinga single pill is a blister package. However, current systems do notprovide a mechanical system suitable for selecting a single blisterpackage of medication from the pharmacy or medication room, andsubsequently dispensing a single dosage from the blister pack bymechanical means is lacking. Additionally, secure institutionalenvironments typically lack an autonomous and/or biometric system forpositive patient identification, patient medication receipt, andmedication consumption verification. Still further, there is an absenceof a real-time feedback loop for administrative personnel to monitorstrict patient compliance with the medication protocol.

In some institutions, medical/pharmacy personnel encounter safetyhazards during the deliver of medications to the patient. The problemscan be worse in a prison environment where medication may becomecurrency. In these situations, an automated medication facility and/orcart having the ability to deliver and dispense the correct medicationto a single patient or a series of patients would be preferred. Such acapability in this environment requires both security and electroniccontrols. Additionally, verification of patient consumption withreal-time feedback or notification will be important. Thus, security,consumption control, verification, feedback and communications areessential to ensure that medication disbursement is not circumvented forother purposes.

In an institutional environment, mass medication delivery will improveoperating efficiency and reduce costs. However, identification of aparticular patient and their specific dose(s) can present a challenge.In many instances, the patient is unaware of the possible druginteractions or the side affects of the particular medication they aretaking. An autonomous system that positively identifies the patient,selects the right medication, delivers the medication, verifies positivepatient consumption and provides real-time feedback with theadministrative medical/pharmacy personnel is highly desired.Additionally, institutions will benefit from an autonomous system thatcan provide real-time drug information to an institutional patient in ahardcopy form simultaneously with dispensing of the medication.

Medication inventory control for institutional entities is anotherdistinct challenge. With a large number of medications ordered anddispensed daily, it is preferred to have a real-time medicationinventory tracking and re-supply linked with the medicationdispensing/delivery function. It is also highly desirable to have theability to automatically track inventory on-hand, inventoryre-supplying/reordering, pharmacy/medication room delivery, patientdelivery, patient information sheets, and drug interaction sheets.Because of the large number of personnel involved in the medicationdelivery process, there are additional concerns about theaccountability, security, and tracking of medication. Often, there is abreakdown and/or a complete lack of medication security and tracking.

The present invention, as described herein, solves the aforementionedproblems and deficiencies.

SUMMARY OF THE INVENTION

In a one embodiment, the current invention provides an automatedmedication delivery system comprising a storage facility, a controller,at least one input station, a retrieval device, a cup, a cup slot, and amed card slot.

The storage facility has a plurality of storage bins. The storage binsare sized for storing a med card.

The controller is in electronic communication with a computer. Thecontroller is attached to the storage facility and adapted to providecontrol of the storage facility.

At least one input station incorporated with the storage facility and inelectronic communication with the controller is provided. The inputstation includes an input port, a positive identification device, and adisplay device. The input port is positioned on a side of the storagefacility for entering a user's personal identification data. The displaydevice provides a menu depicting at least one medication associated witha patient and currently available for dispensing.

The retrieval device is positioned inside of the storage facility and iscapable of retrieving the med cards from the storage bins.

The punchout system is positioned inside of the storage facility and isadapted to receive the med cards from the retrieval device. The punchoutsystem includes a punch and a tray. The tray is sized to hold the medcard and has a plurality of holes thereon. The holes are compatible witha plurality of pills positioned on the med card.

The cup is positioned on a conveyor that is positioned inside of thestorage facility. The cup is positioned below the hole of the punch outand is adapted to receive one of a plurality of the pills from the medcard.

The cup slot is positioned in the side of the storage facility. The cupslot is adapted to receive the cup. The med card slot is positioned inthe side of the storage facility. The med card slot is adapted todispense the med card.

In another embodiment, an automated medication delivery system isprovided. The automated medication delivery system comprises: afacility, a controller, a barcode scanner, an input station, a retrievaldevice, a dispensing device, and a positive consumption device.

The facility includes a secure interior and a plurality of storage binspositioned within the secure interior. The storage bins are sized tostore a med card.

The controller is in electronic communication with a computer. Thecontroller is attached to the facility and is adapted to control thefacility. The controller stores information associated with each of themed cards.

The barcode scanner is positioned within the facility and is capable ofscanning the med cards before insertion into the storage bins and afterremoval from the storage bins. The barcode scanner is in electroniccommunication with the controller.

At least one input station incorporated with the storage facility and inelectronic communication with the controller is provided. The inputstation includes an input port, a positive identification device, and adisplay device. The input port is positioned on a side of the storagefacility for entering a user's personal identification data. The displaydevice displays a menu of at least one medication associated with apatient and that is available for dispensing.

The retrieval device is in electronic communication with the controllerand is positioned within the facility. The retrieval device includes: atrack, an elevation rod, a picker arm, and a retriever. The elevationrod is movably mounted in the track. The picker arm is moveably mountedon the elevation rod. The retriever is attached to the picker arm.

The dispensing device is positioned within the facility. The dispensingdevice includes: a punchout system, a cup, a first conveyor, a secondconveyor, an anti-contamination film, a pill crusher, a cup sweeper, amed card sweeper, at least one cup dispensing slot, and at least one medcard dispensing slot. The punch out is positioned inside of the facilityand is in electronic communication with the controller. The punchoutsystem is adapted to receive the med card from the retrieval device. Thepunchout system includes a punch and a tray. The tray is sized to holdthe med card. The tray has a plurality of holes thereon. The holes arecompatible with a plurality of pills positioned on the med card. The cupis positioned below the holes and is sized to receive one of theplurality of pills. The first conveyor has the cup positioned thereon.The second conveyor is positioned to receive the med card. Theanti-contamination film is mounted on and stretched between a first anda second spool. The pill crusher has a crusher head and is positionedbetween the first and second spools. The anti-contamination film ispositioned between the crusher head and an interior of the cup. The cupsweeper is positioned to move the cup from the first conveyor. The medcard sweeper is positioned to move the med card from said secondconveyor. The cup dispensing slot is positioned to receive the cup fromthe cup sweeper. The med card dispensing slot is positioned to receivethe med card from the med card sweeper.

The positive consumption feedback device is in electronic communicationwith the controller. The positive consumption feedback device includes avideo camera, a microphone, a recorder, and an audio/videocommunications link. The video camera is positioned on the side of thefacility. The recorder is capable of recording video from the videocamera and audio from the microphone. The audio/video communicationslink is with a separate location. The audio/video communications linkprovides real-time video and audio to the separate location.

In yet another embodiment, the current invention provides a mobileautomated medication delivery system comprising: a cart, a plurality ofstorage bins, a controller, a wireless communications device, at leastone input station, a retrieval device, a punchout system, a cup, a cupslot, and a med card slot.

The cart has a plurality of storage bins internally positioned withinit. At least one med card carrying a plurality of medications positionedwithin at least one storage bin is provided.

The controller is in electronic communication with a computer andattached to the cart. The controller is adapted to provide control ofthe cart.

The wireless communications device provides electronic communication forthe controller. The controller is in electronic communication with aremote central control facility.

The input station is incorporated with the cart and is in electroniccommunication with the controller. The input station includes an inputport, a positive identification device, and a display device. The inputport is positioned on a side of the cart and is for entering a user'spersonal identification data. The display device displays a menu of atleast one medication associated with a patient and is available fordispensing.

The retrieval device is positioned inside of the cart and is capable ofretrieving the med cards from the storage bins.

The punchout system is positioned inside of the cart and is adapted toreceive the med card from the retrieval device. The punchout systemincludes a punch device and a tray. The tray is sized to hold the medcard. The tray has a plurality of holes thereon that are compatible witha plurality of pills positioned on the med card.

The cup is positioned on a conveyor that is positioned inside of thecart. The cup is positioned below the holes of the punch out and isadapted to receive a pill from the med card.

The cup slot is positioned in the side of the cart. The cup slot isadapted to dispense the cup. The med card slot is positioned in the sideof said cart. The med card slot is adapted to dispense the med card.

In yet another embodiment, a method for dispensing medication in asecure facility is provided. The method comprises the steps of:

-   -   (a) a requestor logging on to an automated medication delivery        system;    -   (b) identifying said requestor through a security protocol, said        security protocol including:        -   i. said requestor entering a unique identifier associated            with said requestor;        -   ii. said requestor entering a security password/personal            identification number;        -   iii. comparing said entries by said requestor with a            database in a controller electronically connected to and            communicating with said automated medication delivery            system;    -   (c) displaying at least one medication available for a patient        from a list of available medications for said patient, said list        of available medications stored in a patient database;    -   (d) selecting at least one medication from said list;    -   (e) directing said controller to retrieve said medication from a        storage bin located in said automated medication delivery        system;    -   (f) scanning said selected medication with a barcode reader;    -   (g) verifying said scanned medication matches said selected        medication;    -   (h) dispensing said medication according to a pre-selected        protocol;    -   (i) printing a receipt for said patient, said receipt having        information regarding said medication; and    -   (j) updating said patient database.

Numerous objects and advantages of the invention will become apparent asthe following detailed description of the preferred embodiments is readin conjunction with the drawings which illustrate such embodiments.

DRAWINGS

FIG. 1 is a front perspective view of the automated medication deliverysystem.

FIG. 2 is a back perspective view of the automated medication deliverysystem.

FIG. 3 is a back perspective view of the automated medication deliverysystem with the walls removed.

FIG. 4 is an elevation view of the automated medication delivery system.

FIG. 5 is a top view of the automated medication delivery system.

FIG. 6 is a back perspective view of the storage bins and retrievaldevice.

FIG. 7 is a perspective view of the retrieval device.

FIG. 8 is a perspective view of the retrieval device extracting a medcard using a clamp.

FIG. 9 is a perspective view of the retrieval device extracting a medcard using a spatula.

FIG. 10 is a top view of a med card.

FIG. 11 is a perspective view of a tray.

FIG. 12 is an elevation view of a punchout system.

FIG. 13 is a front perspective view of the mobile automated medicationdelivery system.

FIG. 14 is a back perspective view of the interior of the mobileautomated medication delivery system.

FIG. 15 is flow chart of a patient refill request method.

FIGS. 16A and 16B depict the flow chart of a staff member login andretrieval of a patient's medication.

FIG. 17 is a flow chart of the method for loading the automatedmedication delivery system.

FIG. 18 is a flow chart of the filling of the prescription for the medcards.

DETAILED DESCRIPTION

As described herein, the preferred embodiments of the current inventionprovide a method and apparatus related to automatically storing anddelivering medications within an institutional facility. The method andapparatus maintains the security of the medication and ensures patientcompliance with the medicine protocol.

Referring to the drawings and specifically to FIGS. 1-14, the automatedmedication delivery system is illustrated and generally designated bythe numeral 10. FIG. 1 represents a front perspective view of automatedmedication delivery system 10.

Referring to FIGS. 1-5, automated medication delivery system 10 includesa storage facility 12. Storage facility 12 is a secure area having asingle access door 14. Access door 14 is positioned within inner sidewall 16 of storage facility 12 providing access to storage bins 24.Preferably, a plurality of storage bins 24 are positioned along innerside wall 16 and outer side wall 26, aligned in at least two rows.

Each of storage bins 24 are sized to accept med card 28, shown in FIG.10 and described herein. Preferably, storage bins 24 are vertically andlaterally aligned to form a plurality of storage bins 24. As shown inFIG. 5, access panel tray 30 is positioned next to bin end 32 of storagebins 24.

Automated medication delivery system 10 also includes a barcode scanner34. Barcode scanner 34 is positioned near access panel tray 30 or nearbin end 33. Preferably, barcode scanner 34 is positioned to provide asufficient field of view to read barcode 36 of med card 28. It may bedesirable to have at least two barcode scanners 34, with one positionedin each location.

Controller 38 is positioned within storage facility 12 as shown in FIG.5. Controller 38 may be positioned in any location as long as it iselectronically connectable to numerous components of automatedmedication delivery system 10 as identified herein. Controller 38 is inelectronic communication with a computer 40. Controller 38 providesfunctional control for all of automated medication delivery system 10.For example, controller 38 receives input, provides output and real-timefeedback to all systems. Some of the major systems include barcodescanner 34, retrieval device 42, dispensing device 44, first inputstation 46, positive control feedback device 48, and cart 50.

Computer 40 is preferably incorporated into controller 38. However, forsecurity reasons computer 40 may be separated from controller 38.

With reference to FIGS. 1 and 5, first input station 46 includes inputport 52, at least one positive identification device 54, and displaydevice 56. In the preferred embodiment, input port 52 is a keyboard, asshown in FIG. 1; however, input port 52 maybe any device suitable forentering personal identification data into controller 38. Positiveidentification device 54 is preferably a biometric device such as fingerprint reader, retinal scanner, or voice identification device. Displaydevice 56 is a visual display interacting with the requestor.Preferably, display device 56 is a touchscreen device. In onealternative, when display device 56 is a touch screen display device,input port 52 is integrated with display device 56. First input station46 elements, input port 52, positive identification device 54, anddisplay device 56, are in electronic communication with controller 38.

Additionally, first input station 46, input port 52 and display device56 may be used to submit live queries or respond to medical/pharmacypersonnel or security personnel.

Retrieval device 42 is preferably positioned between storage bins 24 andin electronic communication with controller 38. As shown in FIGS. 3-9,retrieval device 42 includes track 58, elevation rod 60, picker arm 62,and retriever 64. Track 58 permits lateral movement of elevation rod 60between storage bins 24. Track 58 supports elevation rod 60 betweenupper component 66 and lower component 68

Elevation rod 60 carries a rotatable collar 70 supporting picker arm 62.Elevation rod 60 provides vertical movement of between storage bins 24for picker arm 62, while rotatable collar 70 allows picker arm 62 torotate 360 degrees about elevation rod 60. Picker arm 62 is able tolaterally move within rotatable collar 70.

Each picker arm end 72 and 74 carries a retriever 64. In one preferredembodiment depicted in FIGS. 6-8, retriever 64 carries clamping device76. In an alternative embodiment depicted in FIG. 9 retriever 64 carriesspatula shaped device 78.

Dispensing device 44 is shown in FIGS. 3-5 and 11. Dispensing device 44includes punchout system 80, cup 82, first conveyor 84, second conveyor86, anti-contamination film 88, pill crusher 90, cup sweeper 92, medcard sweeper 94, first cup dispensing slot 96, second cup dispensingslot 98, first med card dispensing slot 100, second med card dispensingslot 102, a distribution conveyor 104, and water dispenser 106.

Punchout system 80 includes punch 108 and tray 110, and is adapted toextract medication from med card 28. A plurality of holes 112 aredisposed through tray 110 and positioned above catch 114. Catch 114 hascatch opening 116.

With reference to FIG. 10, med card 28 has blisters 118 containing pills120. Positioning of med card 28 in tray 110 aligns blisters 118 withholes 112. Extraction of pills 120 is provided by positioning of punch108 over any one of blisters 118.

With reference to FIGS. 3 and 4, cup feeder 122 is positioned at firstconveyor first end 124. Cup feeder 122 provides a continuous supply ofindividual cups 82 to conveyor 84. First conveyor 84 is adapted toconvey cup 82 to first cup dispensing slot 96 positioned through outerside wall 26 or second cup dispensing slot 98 positioned through firstend wall 126 at first conveyor second end 128.

Anti-contamination film 88 is positioned between and crusher head 134 ofpill crusher 90 and an interior of cup 82. Anti-contamination film 88 iscarried by first spool 130 and second spool 132. First spool 130 andsecond spool 132 are adapted to release a portion of anti-contaminationfilm 88 when crusher head 134 is positioned within the interior of cup82, and to retract anti-contamination film 88 when crusher head 134 isnot in use. First spool 130 and second spool 132 are adapted to moveanti-contamination film 88 after every crushing event. Preferably, pillcrusher 90 moves in an upward and downward direction for crushing pill120. Pill crusher 90, first spool 130, and second spool 132 are inelectronic communication with controller 38.

Second conveyor 86, shown in FIGS. 3-5, receives a complete med card 28.Second conveyor 86 has a second conveyor first end 138 adapted toreceive med card 28 from retrieval device 42. Second conveyor 86 isadapted to convey med card 28 to first med card dispensing slot 100, orsecond med card dispensing slot 102. First med card dispensing slot 100is positioned through outer side wall 26. Second med card dispensingslot 102 is shown positioned through first end wall 126 at secondconveyor second end 140.

Sweep structure 142 supports cup sweeper 92 and med card sweeper 94. Cupsweeper 92 is positioned to move cup 82 from first conveyor 84 to firstcup dispensing slot 96. Med card sweeper 94 is positioned to move medcard 28 from second conveyor 86 to first med card dispensing slot 100.

When requested, first conveyor 84 conveys a plurality of cups 82 throughsecond cup dispensing slot 98 to distribution conveyor 104. Distributionconveyor 104 is shown wrapping around first end wall 126 and onto innerside wall 16. Distribution conveyor 104 is positioned within a secureportion of storage facility 12.

Positive consumption feedback device 48 is shown in FIG. 1. Positiveconsumption feedback device 48 ensures compliance with medical protocolsby providing a video camera 144, microphone 146, recorder 148 andaudio/video communications link 150 to permit monitoring of patientsusing automated medication delivery system 10. Additionally, window 152permits direct human oversight by facility staff standing in or outsideof window 152. Although video camera 144, microphone 146, recorder 148and audio/video communications link 150 can be positioned almostanywhere. In one embodiment, window 152 has video camera 144 andmicrophone 146 positioned above it. Audio/video communications link 150provides a signal to recorder 148 co-located with controller 38.

Dispensing device 44 optionally includes a water dispenser 106. Waterdispenser 106 is adapted to provide water to cup 82 while upon firstconveyor 84, as seen in FIG. 12.

In the preferred embodiment, a printer 158 prepares a receipt for themedication. In one embodiment, printer 158 prepares a receipt near inputport 52. The receipt optionally includes additional informationregarding the medication dispensed. Another embodiment has an additionalprinter near first cup dispensing slot 96 for dispensing a receipt withcup 82. Preferably, another printer 158 is positioned to deposit areceipt with cup 82 exiting second cup dispensing slot 98. Additionally,a portable printer (not shown) may be near window 152 for a staff memberto manually present to the patient.

As depicted in FIG. 10, med card 28 carries a barcode 36. Additionalinformation is also preferably printed on med card 28. The preferredinformation includes identification of the medication, date of issue,number of refills, prescribing medical professional, dosage,administration protocol, warnings, and housing unit, or room of thepatient. Other information can be added as desired. Preferably, database160 stores all information for access by computer 40 through controller38.

Servicing of retrieval device 42, dispensing device 44, barcode scanner34, controller 38, first input station 46, or any other equipment withmedication room 196 is done by qualified personnel. This includesrefilling cup feeder 122, picking up dropped med cards 28, or cleaningspills.

In the preferred embodiment, cart 50 is a mobile extension of automatedmedication delivery system 10. FIGS. 13 and 14 show cart 50 carried bywheels 162. However, cart 50 may use any convenient type of conveyancesuitable for movement through the intended environment. Additionally,cart 50 may have powered wheels 162 for autonomous operations or roboticoperations.

Cart 50 preferably uses a rechargeable battery as a power source (notshown) and includes a suitable charger (not shown) connectable to astandard wall outlet.

Cart 50 has a plurality of internal storage bins 24 sized to store medcard 28. In the preferred embodiment, security is provided by accesspanels 164 that are only openable by the facility staff members with theproper access clearance.

Cart 50 further includes a wireless communication system suitable forcommunicating with controller 38. When operating in an autonomous modeor robotic mode, cart 50 is entirely controlled by controller 38. Inthis situation, controller 38 is a remote central control facility. Atypical wireless communication system will include an antenna 166 andcommunications device 168 positioned within or on cart 50. Additionally,cart 50 has an on-board computer 170 for local control functions.

In the preferred embodiment, cart 50 has a remote input station 172, aremote retrieval device 174, a remote punchout 176, a cup 178, a remotecup dispensing slot 180, and a remote med card slot 182. Each of theseis similar to the ones found in storage facility 12.

Additionally, remote input station 172 includes the same elements asfound in input station 46. Remote input station 172 has input port 52,positive identification device 54, and display device 56. On remoteinput station 172, input port 52 is shown as a keyboard in FIG. 13. Asbefore, input port 52 is suitable for entering personal identificationdata into cart 50 and controller 38. Display device 56 is a visualdisplay interacting with the requestor. Preferably, display device 56 isa touchscreen device. In one alternative, when display device 56 is atouch screen display device, input port 52 is integrated with displaydevice 56. Remote input station 172 is in electronic communication withon-board computer 170 and in wireless electronic communication withcontroller 38.

Remote retrieval device 174 also includes the same elements found inretrieval device 42. Remote retrieval device 174 is shown in FIGS. 13and 14 as being positioned near and providing access to storage bin 24.Remote retrieval device 174 is in electronic communication with on-boardcomputer 170 and in wireless electronic communication with controller38.

FIGS. 13 and 14 show remote retrieval device 174 with track 58,elevation rod 60, picker arm 62, and retriever 64. Elevation rod 60 ismovably positioned on track 58. Within cart 50, track 58 is shown withan upper component 66 and a lower component 68. Track 58 is designed tomove elevation rod 60 laterally between storage bins 24.

Cart 50 uses picker arm 62, which is shown positioned on elevation rod60. Elevation rod 60 is designed to move picker arm 62 verticallybetween storage bins 24. Picker arm 62 is mounted on rotatable collar70. Rotatable collar 70 allows picker arm 62 to rotate 360 degrees aboutelevation rod 60. Picker arm 62 is able to laterally move withinrotatable collar 70. Picker arm 62 in cart 50 also employs eitherclamping device 76 or spatula shaped device 78 as retriever 64. Withincart 50, retriever 64 is attached to at least end 72. Preferably,retriever 64 is attached to both ends 72 and 74 of picker arm 62.

Cart 50 employs a variation of dispensing device 44. As shown in FIG.14, cart 50 uses punchout system 80, which includes punch 108 (not shownin FIG. 14) and tray 110. Tray 110 has a plurality of holes 110 disposedthrough it with catch 114 positioned below tray holes 112 of tray 110.Catch 114 has catch opening 116.

Cart conveyor 184 is adapted to convey a pill 120 extracted by punchoutsystem 80 to remote cup dispensing slot 180. Remote cup dispensing slot180 is shown positioned through outer side wall 26. Remote cupdispensing slot 180 is sufficiently large enough to allow access to pill120 on cart conveyor 184.

Although not shown in FIG. 14, cart 50, an alternative embodimentincludes a pill crusher 90. In this alternative embodiment, pill crusher90, first spool 130, second spool 132, crusher head andanti-contamination film 88 are similarly configured as in storagefacility 12. In cart 50, pill crusher 90, first spool 130, second spool132, crusher head and anti-contamination film 88 are positioned betweentray 110 and cart cup dispensing slot 180. Pill crusher 90, first spool130 and second spool 132 are in electronic communication with on-boardcomputer and in wireless electronic communication with controller 38.

In the alternative embodiment using pill crusher 90, cup feeder 122 isalso used. In this alternative embodiment, cart conveyor 184 receivescups from cup feeder 122 which is positioned at cart conveyor first end186. Cup feeder 122 provides a continuous supply of individual cups 82to cart conveyor 184. Cart conveyor 84 conveys pill 120 positionedwithin cup 82 to remote cup dispensing slot 180. Remote cup dispensingslot 180 is also sufficiently large enough to allow access to cup 82 oncart conveyor 184.

As shown in FIG. 14, cart 50 uses cart shelf 188 to receive a completemed card 28. Cart shelf 188 is positioned adjacent to remote med cardslot 182. Remote retrieval device 174 positions med card 28 sufficientlywithin remote med card slot 182 for a requestor to extract med card 28.

An alternative positive consumption feedback device 48 including videocamera 144, microphone 146, recorder 148 and audio/video communicationslink 150 is optionally integrated with cart 50. Video camera 144,microphone 146, recorder 148 and audio/video communications link 150 arepositioned near remote input station 172 for ease of use. Audio/videocommunications link 150 provides a signal to on-board computer 170 andwirelessly communicates with recorder 148 via controller 38.

In one alternative embodiment, cart 50 includes printer 158. Typically,printer 158 will be located near remote input station 172 for ease ofuse.

Having described the preferred embodiments of the apparatus of thecurrent invention, the following discussion will focus on the preferredmethods for automatically delivering medication using the automatedmedication delivery system 10. The following detailed discussion willbreak the method into six sub-methods, as shown in FIGS. 15-18. Thefirst sub-method begins with the actual prescription process. The methodincludes the following steps, which are shown in FIG. 18:

-   -   a. A physician writes a prescription for medication(s) for a        patient;    -   b. the prescription is transmitted to a pharmacy via computer or        facsimile;    -   c. the pharmacy fills the prescription into med cards 28 having        blisters 118;    -   d. the pharmacy records patient information and medicine        information into database 160, and associates that information        with barcode 36 that is printed on med card 28;    -   e. the patient information and prescription information are        printed onto med card 28;    -   f. the pharmacy ships med cards 28 to facility via approved,        overnight shipping agent; and    -   g. the staff receives, inspects, records anomalies and loads        medicine cards loaded into automated medication delivery system        10.

The second sub-method highlights the loading process and is shown inFIG. 17. In this sub-method, the medical staff preferably inputs medcard 28 into storage facility 12. The group of med cards 28 is receivedfrom the pharmacy. Each med card 28 has all of the pertinent patientinformation already printed upon it, along with barcode 36 thatassociates the patient information and medication.

The staff member, or members, enters medication room 196 through accessdoor 14 with med cards 28 received from the pharmacy. Each med card 28is inspected by at least one staff member for completeness, accuracy andany missing medications. All missing medications on med card 28 areidentified by individual blisters 118. The information is entered intoterminal 194, which is in electronic communication with controller 38and database 160.

The staff member places the inspected med card 28 onto access panel tray30. In one embodiment, controller 38 engages barcode scanner 34 torecord barcode 36 while med card 28 is upon access panel tray 30. Inanother embodiment, controller engages barcode scanner 34 after removingmed card 28 from access panel tray 30. In an alternative embodiment, thestaff member directly places med card 28 into storage bin 24 and engagescontroller 38, automatically or through terminal 194, to use retrievaldevice 42 to remove, scan and store it.

Controller 38 next engages retrieval device 42 using retriever 64 topick up the scanned med card 28. Controller 38 assigns med card 28 to anempty storage bin 24 and moves retrieval device 42 to insert med card 28therein.

The third sub-method highlights the patient request process. Thisprocess is similar to the fourth sub-method shown in FIGS. 16A and 16B.The third sub-method is demonstrated through an example operation ofstorage facility 12. In the example, the facility is a prison or largeinstitutional hospital.

A patient approaches the first input station 46. Using input port 52 anddisplay device 56, the patient proceeds to login by entering a uniquenumber assigned to them, along with a personal identification number.Positive identification device 54 in this instance is a finger printbiometric device. The patient places their finger on positiveidentification device 54 for verification of their identity. A receiptis printed and dispensed to the patient using printer 158.

Once the patient's identity is verified, a menu of at least onemedication associated with that patient is shown on display device 56.The menu indicates all medication available for dispensing at that time.Using first input station 46, the patient makes a request for themedication by selecting the medication desired. If several medicationsare available, the menu allows the patient to select all dispensablemedications.

Upon receipt of the request, controller 38 identifies the specificstorage bin 24 containing the patient's med card 28. Controller 38 alsoidentifies that the medication is not a “keep on person” medication andthat the medication must be crushed. As known to those skilled in theart, institutions identify certain medications as “keep on person”medications when those medications must remain with the patient. Forexample, a patient with severe asthma may need to carry their medicationwith them at all times in the event of an asthma attack.

Controller 38 moves picker arm 62 vertically and laterally to positionretriever 64 immediately adjacent to the specific storage bin 24containing the patient's med card 28. Controller 38 extends picker arm62 through rotatable collar 70 until retriever 64 clamps med card 28.Controller 38 next retracts picker arm 62 to a neutral position.

Controller 38 moves picker arm 62 vertically and laterally to positionretriever 64 adjacent to barcode scanner 34. Controller 38 again extendspicker arm 62 through rotatable collar 70 to scan barcode 36 on med card28. Picker arm 62 is again retracted to a neutral position. Dependingupon the particular location of storage bin 24, rotatable collar 70 mayhave rotated picker arm 62 one or more times to scan barcode 36.

Controller 38 moves picker arm 62 vertically and laterally until medcard 28 is aligned with tray 110. Once aligned, controller 38 extendspicker arm 62 through rotatable collar 70 to place med card 28 onto tray110. Since tray 110 is sized to accept med card 110, blisters 118 arealigned with holes 112. Depending upon the particular location ofstorage bin 24, rotatable collar 70 may have rotated picker arm 62 oneor more times to align med card 28 with tray 110. Picker arm 62 mayoptionally release med card 28. In the preferred embodiment, picker arm62 retains med card 28 until after punchout system 80 is through withthe extraction process of pill 120.

Controller 38 operates punchout system 80 once med card 28 is positionedon tray 110. Controller 38 memory contains the location of all remainingpills 120 in med card 28. Preferably, controller 38 moves punch 108 to aposition over blister 118 containing pill 120. Alternatively, picker arm62 and retriever 64 release med card 28, allowing tray 110 to move andposition blister 118 under punch 108. Controller 38 moves punch 108 in adownward direction to push pill 120 through blister 118. Pill 120 fallsthrough hole 112 into catch 114 and out catch opening 116. Since catch114 is funnel shaped, it does not matter which pill 120 is extracted.

Controller 38 has previously released cup 82 from cup feeder 122 atfirst conveyor first end 124. Controller 38 positions cup 82 under catchopening 116 by moving cup 82 on first conveyor 84.

Once pill 120 is extracted, controller moves picker arm 62 back to aneutral position on rotatable collar 70. This movement removes med card28 from tray 110. Preferably, controller 38 moves picker arm 62 toreplace med card 28 in the same storage bin 24.

Once pill 120 is in cup 82, controller 38 moves first conveyor 84 toposition it under pill crusher 90. Controller 38 moves crusher head 134in a downward motion until it enters interior 136 of cup 82 and engagespill 120. Pill 120 is crushed by crusher head 134. Anti-contaminationfilm 88 protects crusher head 134. Crusher head is moved upward to aneutral position. Once in the neutral position, controller 38 causesfirst spool 130 and second spool 132 to rotate and remove thecontaminated portion of anti-contamination film 88 from near crusherhead 134.

Controller 38 engages first conveyor 84 to move cup 82 to a position infront of first cup dispensing slot 96. Once positioned, controller movescup sweeper 92 to push cup 82 into first cup dispensing slot 96. Printer158 produces a receipt and deposits the receipt in or near cup 82 whilecup 82 is in first cup dispensing slot 96. The patient is now able toaccess their medication.

Controller 38 updates database 160 with the details of the transactionto include the specific pill extracted from med card 28.

If the patient is to receive “keep on person” medication, controller 38directs delivery of med card 28 to second conveyor first end 138. Oncemed card 28 is on second conveyor 86, controller 38 moves secondconveyor 86 until med card 28 is positioned in front of first med carddispensing slot 100. Once there, controller 38 engages med card sweeper92 to push med card 28 into first med card dispensing slot 100. Printer158 produces a receipt and deposits the receipt with med card 28 whilemed card 28 is in first med card dispensing slot 100. The receipt maycontain additional information about the medication to include druginteraction warnings and side effects. The patient is now able to accesstheir medication.

The fourth sub-method is for a staff member to request medication for agroup of patients, an entire housing unit or an entire wing. The fourthsub-method is shown in FIGS. 16A and 16B.

In some situations, patients are unable to come to a central medicationdistribution site. Thus, facility staff member may need to retrieve allof the medication for a particular room, housing unit, or wing. In thatsituation, the staff member approaches a second input station (notshown) and logins using a second input port (not shown), a seconddisplay device (not shown), and a second positive identification device(not shown). Second input station is preferably positioned in near innerside wall 16 or first end wall 126. Second input station is also inelectronic communication with controller 38.

After the staff member enters their unique identifying number andpersonal identification number, they may be required to further providepositive identification by a finger print scanner, retinal scanner, orvoice identification device. Once the staff member's identity isverified by controller 38, they will have a different set of menuoptions presented to them. Preferably, the staff member is able toselect an individual patient, a group of patients, an entire housingunit or wing, and/or a combination thereof. From that grouping, thestaff member selects the medication to be dispensed at that time.Controller 38 has the medical records of the patients on file and isable to determine which medication must be dispensed.

Controller 38 repeats most of the process used for the individualpatient identified in the third sub-method, but it does not use cupsweeper 92 or med card sweeper 94. Instead, controller 38 uses firstconveyor 84 to deliver all of the medication in cups 82 through secondcup dispensing slot 98. Printer 158 prints the patient information foreach cup 82. At that point, controller 38 moves cups 82 on distributionconveyor 104. The staff member removes cups 82 from distributionconveyor 104. A safety check device 190 provides feedback to controller38 to prevent cups 82 from falling off of distribution conveyor 104.

Additionally, controller 38 uses second conveyor 86 to deliver all medcards 28 that are “keep on person” medications to second med carddispensing slot 102. The med cards 28 are delivered to catch basket 192.The staff member removes all med cards 28 from catch basket 192.

The fourth sub-method highlights the staff request process. The methodincludes the following steps shown in FIGS. 16A and 16B:

-   -   a. The staff member logs into the second input port with        appropriate identifier;    -   b. the staff member selects the option to retrieve all        medication for a particular patient, group of patients, housing        unit or wing;    -   c. controller 38 identifies if any of the medication is “keep on        person” (KOP) medication    -   d. if any of the medication is a KOP medication, controller 38        directs retrieval device 42 to use picker arm 62 and retriever        64 to retrieve med card 28:        -   i. barcode 36 on med card 28 is scanned and verified that            medication is correct for patient;        -   ii. the entire med card 28 is passed through second med card            dispensing slot 102 to catch basket 192;        -   iii. database 160 is electronically updated;    -   e. If none of medication is a KOP, controller 38 directs        retrieval device 42 using picker arm 62 and retriever 64 to        retrieve med card 28:        -   i. retrieval device 42 using picker arm 62 moves med card 28            to punchout system 80;        -   ii. barcode 36 on med card 28 is scanned to verify the            correct medication is being dispensed for the correct            patient;        -   iii. med card 28 is positioned to allow the next individual            pill 120 to be punched out, extracted, from blister 118 on            med card 28;        -   iv. individual pill 120 is punched out and falls into cup            82;        -   v. database 160, medication administration records, are            electronically updated;        -   vi. database 160 information on med card 28 is updated to            determine where next punchout should occur on med card 28;        -   vii. controller 38 directs retrieval device 42 using picker            arm 62 to return med card 28 to its storage bin 24;        -   viii. cup 82 is moved on first conveyor to pill crusher 90            station;        -   ix. controller 38 identifies if pill 120 is to be crushed;            if so, pill(s) 120 are crushed using crusher head 134;            otherwise cup 82 is further conveyed to second cup            dispersing slot 98; and        -   x. printer 158 prints a receipt showing the medication            retrieved; the receipt is placed on or in cup 82.

The fifth sub-method relates to a patient's refill request of medicationor a staff member's request for a refill of a medication for a patient.This sub-method is shown in FIG. 15. Controller 38 will display allmedications needing refills as part of the original display. If thepatient or staff member is only requesting a refill, they may go throughthe same login process and select that particular option. The fifthsub-method is further outlined in the following steps:

-   -   a. The patient or staff member logs into first input station        using their unique identifying number, personal identification        number, and presenting a positive identification;    -   b. the positive identification is made through fingerprint scan,        retinal scan, or voice identification;    -   c. the medication(s) the patient is authorized to refill is        shown on display device 56;    -   d. the patient or staff member identifies any or all medications        to be refilled;    -   e. if the medication is selected for refill, the refill order is        automatically sent to the pharmacy and the medical staff is        notified that a refill order was transmitted; and    -   f. if the refill order was rejected by the patient or staff        member, the medical staff notified that refill order was        rejected.

The sixth sub-method relates to the mobility of automated medicationdelivery system 10. As shown below, cart 50 is used to delivermedication within a facility. Cart 50 may be pushed by a staff member.Alternatively, cart 50 may be semi-autonomous and move through thefacility with a staff member. In still another alternative, cart 50operates autonomously without a staff member. In all situations, cart 50is in wireless electronic communication with controller 38 and facilitystaff.

Cart 50 is loaded with med cards 28 by an authorized staff member. In asecure environment, a staff member opens secure access panels 164 tohave access to storage bins 24. The staff member uses a remote barcodescanner (not shown) to scan barcode 36 and record the information inon-board computer 170 and controller 38. The remote barcode scanner ismounted within cart 50, and is in electronic communication with on-boardcomputer 170 and controller 38.

The staff member places med card 28 inside of cart 50 under remotebarcode scanner. Remote barcode scanner triggers remote retrieval device174 to collect med card 28. Remote retrieval device 174 selects an emptystorage bin 24 and moves med card 28 to that storage bin 24. On-boardcomputer 170 is performing local control of remote barcode scanner andremote retrieval device 174. The particular med card 28 information andstorage bin 24 information are locally stored and transmitted tocontroller 38. The med card 28 information is compared with database 160by controller 38. Any anomalies are identified to the on-board computer170, which has remote retrieval device 174 remove med card 28. Once allanomalies are resolved, the med card 28 having trouble is reloaded.After all med cards 28 are loaded, secure access panels 164 are secured.

Once cart 50 is loaded, on-board computer 170 directs it to deliver themedication. Preferably, cart 50 delivers medication to a single room orpatient. However, cart 50 can be programmed to deliver medication to alocation with several patients.

When the patient accesses cart 50, they use remote input station 172 tologin. Using input port 52 and display device 56, the patient proceedsto login by entering a unique number assigned to them, along with apersonal identification number. Preferably, the patient further verifiestheir identity using positive identification device 54. Positiveidentification device 54 is preferably a biometric device, as describedabove.

Since, the need for cart 50 implies a higher security area to beserviced, on-board computer 170 records the entire transaction usingvideo camera 144 mounted near remote input station 172. Additionally,the date, time and all other pertinent information is recorded. Therecording is wirelessly transmitted to controller 38.

Once the patient's identity is verified, a menu of at least onemedication associated with that patient is shown on display device 56.The menu indicates all medication available for dispensing at that time.Using remote input station 172, the patient makes a request for themedication by selecting the medication desired. If several medicationsare available, the menu allows the patient to select all dispensablemedications.

Upon receipt of the request, on-board computer 170 identifies thespecific storage bin 24 containing the patient's med card 28. On-boardcomputer 170 also identifies if the medication is a “keep on person”medication, an individual dosage, and if that individual dosage shouldbe crushed.

Within cart 50, on-board computer 170 engages remote retrieval device174. Picker arm 62 is moved vertically and laterally to positionretriever 64 immediately adjacent to the specific storage bin 24containing the patient's med card 28. On-board computer 170 extendspicker arm 62 through rotatable collar 70 until retriever 64 retrievesmed card 28. On-board computer 170 next retracts picker arm 62 to aneutral position.

On-board computer 170 next moves picker arm 62 vertically and laterallyto position retriever 64 adjacent to barcode scanner 34. On-boardcomputer 170 again extends picker arm 62 through rotatable collar 70 toscan barcode 36 on med card 28. Picker arm 62 is again retracted to aneutral position. Depending upon the particular location of storage bin24, rotatable collar 70 may have rotated picker arm 62 one or more timesto scan barcode 36.

Once med card 28 is scanned, on-board computer 170 moves picker arm 62vertically and laterally until med card 28 is aligned with tray 110.Once aligned, on-board computer 170 extends picker arm 62 throughrotatable collar 70 to place med card 28 onto tray 110. Since tray 110is sized to accept med card 110, blisters 118 are aligned with holes112. Depending upon the particular location of storage bin 24, rotatablecollar 70 may have rotated picker arm 62 one or more times to align medcard 28 with tray 110. Picker arm 62 may optionally release med card 28.In the preferred embodiment, picker arm 62 retains med card 28 untilafter punchout system 80 is through with the extraction process of pill120.

On-board computer 170 operates punchout system 80 once med card 28 ispositioned on tray 110. On-board computer 170 memory contains thelocation of all remaining pills 120 in med card 28. Preferably, on-boardcomputer 170 moves punch 108 to a position over blister 118 containingpill 120. Alternatively, picker arm 62 and retriever 64 release med card28, allowing tray 110 to move and position blister 118 under punch 108.On-board computer 170 moves punch 108 in a downward direction to pushpill 120 through blister 118. Pill 120 falls through hole 112 into catch114 and out catch opening 116. Since catch 114 is funnel shaped, it doesnot matter which pill 120 is extracted.

If an alternative embodiment utilizing pill crusher 90 is used, cup 82is internally positioned. In this alternative embodiment, on-boardcomputer 170 has previously released cup 82 from cup feeder 122 at cartconveyor first end 186. On-board computer 170 positions cup 82 undercatch opening 116 by moving cup 82 on cart conveyor 184.

Once pill 120 is extracted, controller moves picker arm 62 back to aneutral position on rotatable collar 70. This movement removes med card28 from tray 110. Preferably, on-board computer 170 moves picker arm 62to replace med card 28 in the same storage bin 24.

Once pill 120 is in cup 82, on-board computer 170 moves first conveyor84 to position it under pill crusher 90. If pill 120 is to be crushed,on-board computer 170 moves crusher head 134 in a downward motion untilit enters interior 136 of cup 82 and engages pill 120. Pill 120 iscrushed by crusher head 134. Anti-contamination film 88 protects crusherhead 134. Crusher head is moved upward to a neutral position. Once inthe neutral position, on-board computer 170 causes first spool 130 andsecond spool 132 to rotate and remove the contaminated portion ofanti-contamination film 88 from near crusher head 134.

If pill 120 is not be crushed, or after being crushed, on-board computer170 engages first conveyor 84 to move cup 82 to a position in front ofremote cup dispensing slot 180. Once positioned, printer 158 produces areceipt and deposits the receipt in or near cup 82 while cup 82 is inremote cup dispensing slot 180. The patient is now able to access theirmedication.

If the alternative embodiment is not used having pill crusher 90receiving cup 82 from cup feeder 122, cart conveyor 184 receives pill120 and positions it in front of remote cup dispensing slot 180.

In yet another embodiment, using pill crusher 90 and not cup feeder 122,the patient selects cup 82 from external cup feeder 198, removes pill120 from cart conveyor 184, inserts pill 120 into cup 82 and places cup82 under pill crusher 90. On-board computer 170 knows to detect if cup82 is positioned under crusher 90 through a detector (not shown). Oncecup 82 is in position, pill crusher 90 engages and crushes pill 120.After the crushing event, the patient removes cup 82 with pill 120 init.

On-board computer 170 updates database 160 via controller 38 with thedetails of the transaction to include the specific pill extracted frommed card 28.

If the patient was to receive “keep on person” medication, controllerwould have delivered med card 28 to cart shelf 188. Remote retrievaldevice 174 pushes med card 28 out remote med card dispensing slot 182 asufficient distance so that the patient may grab med card 28. Printer158 produces a receipt for the patient. The receipt may containadditional information about the medication to include drug interactionwarnings and side effects. The patient is now able to access theirmedication.

An automated update of the entire transaction is recorded by on-boardcomputer 170 and transmitted to database 160 via controller 38.

Therefore, it will be seen that the apparatus and method of the presentinvention are well adapted to carry out the ends and advantagesmentioned, as well as those inherent therein. While a presentlypreferred embodiment of the apparatus and method have been described forthe purposes of this disclosure, numerous changes in the arrangement andconstruction of parts in the apparatus, and steps in the method, may bemade and executed by those skilled in the art. All such changes areencompassed within the scope and spirit of the appended claims.

1. An automated medication delivery system comprising: a plurality of storage bins; a plurality of med cards each carrying a plurality of medications and each positioned within one of said storage bins; a controller in electronic communication with a computer wherein said controller stores information associated with each of said med cards; at least one scanner positioned within said facility and capable of scanning said med cards before insertion into said storage bins and after removal from said storage bins; said scanner in electronic communication with said controller; an input station in electronic communication with said controller, said input station for identifying a user and interacting with said user so said user can select at least one of said medications; a retrieval device in electronic communication with said controller and positioned to retrieve said med card from said plurality of storage bins based on said user's selection; a dispensing device position to receive said med card from said retrieval device; wherein said dispensing device can dispense one of said medications or one of said plurality of med cards to said user.
 2. The automated medication delivery system of claim 1 wherein said input station comprises: an input port for entering said user's personal identification data; a positive identification device; a display device; and a means for displaying said medications associated with a patient and said medications available for dispensing.
 3. The automated medication delivery system of claim 2 wherein said positive identification device is biometric device selected from the group consisting of a finger print identification device, a retinal scan identification device, and a voice identification device.
 4. The automated medication delivery system of claim 1 wherein said retrieval devices comprises: a track; an elevation rod moveably mounted in said track; a picker arm movably mounted on said elevation rod; and a retriever attached to said picker arm.
 5. The automated medication delivery system of claim 1 wherein said plurality of medications is a plurality of pills and said dispensing device comprises: a punchout system in electronic communication with said controller, said punchout system adapted to receive said med card from said retrieval device, said punchout system including: a punch; and a tray sized to hold said med card, said tray having a plurality of holes thereon, wherein said holes are compatible with said plurality of pills position on said med card; a cup positioned below said holes, said cup sized to receive one of said plurality of pills; a pill crusher having a crusher head and positioned between said first and second spools, wherein said anti-communication film is positioned between said crusher head and an interior of said cup; a first conveyor having said cup positioned thereon; a second conveyor being positioned to receive said med card; an anti-contamination film mounted on an stretched between a first and second spool; a cup sweeper positioned to move said cup from said first conveyor; a med card sweeper positioned to move said med card from said second conveyor; at least one cup dispensing slot, said cup dispensing slot being positioned to receive said cup from said cup sweeper; and at least one med card dispensing slot, said med card dispensing slot positioned to receive said med card from said med card sweeper.
 6. The automated medication delivery system of claim 1, further comprising: a positive consumption feedback device in electronic communication with said controller; and an audio/video communications link with a separate location, said audio/video communications link provided real-time positive consumption feedback to said separate location.
 7. A method for dispensing medication comprising: entering a unique identifier associated with a requestor into and input station in electronic communication with a controller, said controller also being in electronic communication with an automated delivery system; identifying said requestor through a security protocol which utilizes said unique identifier; obtaining information from said requestor through said input station, said information related to medications, comparing said information with a database in said controller; selecting at least one medication based on said comparison; directing said automated medical delivery system through said controller such that said automated medical delivery system retrieves a med card containing said at least one medication from a storage bin located in said automated medical delivery system, wherein said med card has information pertaining to said medication; scanning said med card with a scanner in communication with said controller; verifying said scanned medication matches said selected medication; dispensing said medication to said requestor according to pre-selected protocol; and updating said database.
 8. The method of claim 7 wherein said dispensing by said pre-selected protocol comprises: identifying all medications in said med card designated as being a keep on person medication; delivering said med card designated as keep on person medications to a slot in said automated medication delivery system; passing said med card to said requestor through said slot; and repeating until all med cards requested are dispenses.
 9. The method of claim 7 wherein said dispensing by said pre-selected protocol comprises; identifying all medication designated as an individual dose medication; identifying a location on said med card of said medication to be dispensed next; delivering said med card to a punchout system, said delivering accomplished by a retrieval device positioned inside said automated medication delivery system; removing said medication to be dispensed from said med card in said punchout system; delivering said medication to be dispensed to a slot in said automated medication delivery system; passing said medication to be dispensed to said requestor through said slot; and repeating until all medications requested are dispensed.
 10. The method of claim 9 wherein the steps of removing said medication to be dispensed from said med card and delivering said medication to be dispensed to a slot further comprise: positioning said med card on said punchout system where said medication is positioned over a hole in a tray sized to hold said med card; punching out said medication from said med card using a punch; receiving said pill in a cup, said cup positioned upon a conveyor; removing said med card from said punchout system; returning said med card to said storage bin; moving said conveyor until said cup is positioned under a pill crusher; replacing said cup under said punchout system with a new cup; crushing said medication for those that are prescribed to be crushed; moving said conveyor until said cup is positioned under a printer; printing a receipt with said printer; depositing said receipt into said cup; moving said conveyor until said cup passes through a slot, thereby dispensing said medication to said requestor; and repeating until all individual doses requested are dispensed.
 11. The method of claim 7, wherein said step of entering a unique identifier includes inputting a biometric identifier using a biometric device, and wherein the step of identifying said requestor, further comprising an additional step of verifying said identity of said patient with said biometric device.
 12. A mobile delivery system comprising: a cart having a secure interior; a plurality of storage bins internally positioned within said secure interior, said storage bins sized to store a med card; an on-board computer in wireless electronic communication with said controller, wherein said on-board computer is attached to said cart and provides local control of said cart; a wireless communications device providing electronic communication for said on-board computer; at least one remote input station incorporated with said cart and in electronic communication with said on-board computer, said input station including: an input portion positioned on said cart for entering a user's personal identification data; a positive identification device; a display device; a menu displaying at least one medication associated with a patient, said medication available for dispensing, said menu presented on said display device; a remote retrieval device positioned inside of said cart capable of retrieving said med cards from said storage bins; a punchout system positioned inside of said cart and adapted to receive said med card from said retrieval device, said punchout system including: a punch; and a tray sized to hold said med card, said tray having a plurality of holes thereon, wherein said holes are compatible with a plurality of pills positioned on said med card; a cup slot positioned in a side of said cart, said cup slot adapted to dispense said cup; and a med card slot positioned in said side of said cart, said med card slot adapted to dispense said med cart.
 13. The mobile delivery system of claim 12, wherein said cart is robotic.
 14. The mobile delivery system of claim 12, further comprising a pill crusher positioned inside of said storage facility between said punchout system and said cup slot when said cup is below said plurality of holes, said pill crusher having an anti-contamination film positioned between a crusher head and an interior of said cup.
 15. The mobile delivery system of claim 12, wherein said retriever is positioned adjacent to said storage bins, said retriever further including: a track positioned above said storage bins, said track extending along at least a length of said storage bins; an elevation rod movably positioned in said track; a picker arm movably positioned on said elevation rod; and a retriever attached to said picker arm.
 16. The mobile delivery system of claim 12, wherein said retriever is a clamp.
 17. The mobile delivery system of claim 12, wherein said retriever is a spatula.
 18. The mobile delivery system of claim 12, wherein said positive identification device includes a biometric identification device.
 19. The mobile delivery system of claim 12, wherein said cart has at least one secure access panel.
 20. The mobile delivery system of claim 12, further comprising a scanner positioned within said cart, and capable of scanning said med cards before and after insertion into said storage bins. 